My decision to create this site was made because of the many questions I get as a dentist from parents regarding their children’s oral health. It seems that many of the “What to Expect ” books and childcare guides omit something very critical in raising and caring for children. A subject that is so simple but so easily dismissed as common knowledge or topics that your pediatrician will discuss with you. Unfortunately, most pediatricians know VERY LITTLE about the dental health of your child. So, this leaves many parents wondering if they are providing adequate dental care for their children. Too often this lack of knowledge causes irreversible damage to their kid’s teeth and a serious dent in their wallets.

I hope you find the information on this site to be a  mildly humorous, very informative, myth-busting, easy to understand guide that should help you feel confident that you are on the right track with your child’s oral health. My other hope is that this knowledge will allow you to save money when it can be saved, and to spend it when it really needs to be spent.

These questions were chosen because they are by far the most common I receive at the dental office or more often, when I am at social functions for my own kids! The answers are then provided in a way which I think just about everyone can understand. I hope after reading some of these posts, you find yourself empowered and fully informed.
I hear all of these questions far too often, which leads me to believe that there is a serious lack of knowledge on the subject. Since dental decay in children is the #1 childhood disease, it is very important that parents are well educated on the subject. I feel strongly that we can better help the future of our children if we can share the knowledge to prevent these dental problems. These problems are far too often physically, mentally and financially challenging for parents and children, both short and long term. So, my hope is that after you find something useful or helpful, you feel confident in sharing the vital information with others so that they too can avoid some of the costly or worrisome situations.
You may also have friends in your social circle with younger children who may have questions that you will now feel confident answering for them. Even though you may only have a teenager now, life can be full of many unplanned miracles-so it is always better to be prepared now! Whatever the reason, share the knowledge with your friends and family.

In the last decade, cosmetic dental services, including tooth whitening, has grown to a multi-billion dollar industry. More, now than ever, even in a down economy, people are still paying top dollar to improve their smiles. Some may argue that even more money is being spent on cosmetic teeth whitening than before, as an aid to increase competition in this already difficult job market.

There are many ways to whiten teeth and much of choosing depends on the person’s goals and personal preferences. Home whitening kits, both professional and over-the-counter can be successful, depending on the magnitude of white teeth a patient desires, as well as the initial color and yellowness of the teeth to be whitened. If teeth are extremely dark, then whitening of the teeth by the dentist may be necessary in order to achieve a patient’s cosmetic desires.

A visit to the dentist prior to starting any teeth whitening treatments is recommended, as there are situations that teeth whitening may be harmful to the teeth. In addition, you may actually save money by whitening in a way specific to your teeth rather than blindly spending money on things that may not work on you.

There are many over-the-counter tooth whitening kits available with many different types and concentration of bleach. Be sure to educate yourself on what you are buying in order to increase your chances of the whitest, brightest smile for the money!

This is a question I get asked frequently and has an answer which provides a huge relief for many parents. In most cases, these yellower teeth are completely normal. It’s actually considered to be an optical illusion! You see, baby teeth, as mentioned earlier are actually nick-named “milk-teeth” because of their bright, white color. They are beautiful, delicate and oh-so adorable. Then, our permanent teeth make their appearance right beside those beauties. Permanent teeth are actually much yellower than baby teeth and often appear big and “gangly.” So, when sitting adjacent to something so spectacular such as baby teeth, they can appear downright ugly at times.

If you don’t make mention of it to your child, they often don’t even notice and therefore won’t become self conscious. The issue is that some people truly do have naturally darker teeth than others. Color and whiteness shades are highly variable and can also run in families. This is why whitening products have become so popular in our culture today. Once your child’s permanent teeth have all come in, re-evaluate the color then and see how they appear to you. My guess is that they will not appear as yellow/dark as they first did while next to the “milk-white” teeth. If they are, and if the child is self conscious, whitening toothpaste and possible whitening agents can be considered once the child is at the age appropriate time.

There is also another cause of yellow teeth in children which can be a quick fix-depending on your child. Often times the discoloration is caused by poor oral hygiene. If the child does an inadequate job at brushing, or refuses to brush regularly, a thick layer of yellow plaque builds up on the teeth. This can make teeth appear up to 3-4 shades darker than they actually are. So, look at your child’s teeth carefully. If you see a layer of “fuzzy” looking film that looks as if it could be scraped off, then you likely have your culprit.

There are generally not many foods or drinks that will cause staining at this age, unless you are allowing your child to have red wine or coffee! Iced or hot tea can also cause staining which is easily removed during regular dental check-ups. If your child has the dreaded “fuzzy’ layer and also drinks sodas frequently, the staining may be exaggerated. Smoking can also cause staining, but if your child is smoking at this age, then I suspect you have bigger worries than yellow teeth!

One last note to mention here. There are other causes of darker teeth and if you feel that these above are not the reasons for it, please see your dentist for an evaluation. There are multiple genetic disorders and diseases which can affect tooth color. These disorders can cause yellowing, but more importantly can affect the overall integrity of the teeth.

Examples of these disorders include but are not limited to: Amelogenesis Imperfecta and Dentinogenesis Imperfecta (each with sub-type categories). These disorders, cause defective enamel or other tooth tissues, can give a “flaking away” quality and appearance of tooth, rather than yellowing alone. There are ranging severities of the disorder and thus the appearance will vary from person to person. Though yellowing alone is uncommon in these disorders, it still can be the only obvious sign. When in doubt, check with your dentist, as these disorders need special attention in order to keep the teeth healthy. If the teeth appear red, green or brown or any other abnormal color, please see your dentist or physician immediately.

The answer I am going to give you is going to sound ridiculous at first, but if you listen to my reasons, you will see exactly why we recommend the following:  In general, a child should first see the dentist when their first tooth comes in.  There are two reasons for this.  The biggest one, at least the one they teach us in dental school, is because teeth exhibit many possible signs of underlying bodily diseases that may otherwise not be discovered until a much later time.  There are many genetic disorders and syndromes that show their signs first in the teeth before in any other part of the body.  A few examples include ectodermal dysplasia, amelogenesis and dentinogenesis imperfecta and many more. While most of these disorders are indeed somewhat rare, I think common sense tells us that the sooner we can catch them, the better opportunity we have to treat them.

In addition to this, parents must remember a long used phrase about children: “Kids are NOT little adults.”  Now, I am sure this makes complete sense to you when you think about the daily things, like why kids think it is fine to eat mac n’ cheese for every meal or why they still can’t put their shoes on the right feet at 10 years old.  Or how they can have 103 degree fever and still be functional when us adults would be bedridden and begging to be put out of our misery.   So, this phrase is applicable in many areas, but is particularly true in the world of dentistry.

One thing parents need to know about their kid’s teeth is that children’s teeth are “softer” than adult teeth and therefore decay at a much faster and easier rate.  Not only are they more susceptible to decay, their nerve tissue within the tooth is much closer to the outside of the tooth than an adult.  This makes it much more likely that they will need a “child root canal” or extractions, even with the presence of only small amounts of decay.  So, with this in mind, we can see how an early trip to the dentist can minimize problems which may have otherwise become huge problems by waiting.

Another important thing to know is that those baby teeth which seem so unimportant are actually a blessing in disguise.  As you will read in subsequent chapters, those little teeth will help pave the way for the future position of the permanent teeth.  Extracting them prematurely can cause many cosmetic and functional problems which can be very costly later on.

While I am a dentist, my most challenging job is being a mom.  That is why I actually feel that this next reason for going to the dentist at an earlier age is one of the most important. I have rarely seen a child in this age range that is eager and excited to hop up in a large, squeaky chair, in an unfamiliar place and open their mouths for a total stranger wearing latex gloves and a scary mask.

To top it off we expect them to open willingly and let us come at them with large, sharp instruments. Yikes!  If they scream just sitting on Santa’s lap, what makes us think they will be excited about going to the dentist?  If we take our children young enough and make it a fun place without all the scary stuff first, then their visits will be an experience to look forward to rather than fear.  So, the mom side of my persona always wants me to create fun and wonderful experiences for my kids and the kids I treat.  The earlier they start seeing the dentist, the less fearful they will be.

I usually suggest that you bring them in with you when you have your own cleanings done every six months (provided you, yourself are not a big chicken).  This will reinforce that you are not scared and get them familiarized with the office so that they are comfortable with the surroundings.  Eventually, the child will recognize your dental office and look forward to coming with you because they always get a toothbrush, a sticker and a sugar-free lollipop!  The biggest miracle of all is, that after a few times, you’re little one will actually beg the dentist to look at their teeth and will ask them to be cleaned.  Easy as taking candy from a baby (which, by the way, your baby shouldn’t have candy in the first place-but we’ll talk about that more later)!

If you, as a parent, are a dental-phobe, then have your spouse or someone else take your child so that they ALWAYS begin their dental journey with nothing but a positive experience.  Keep in mind that if someone other than the child’s legal guardian takes the child, you will need to give the caretaker some form of written and/or verbal consent for treatment.  The laws vary by state, so be sure to inform yourself and also keep good communication with the dental office staff about treatment and finances involved in your child’s care.

If your child is still uncooperative despite all efforts, or your current dentist is not great with kids, then I would highly recommend seeing a pediatric dentist.  This kind of dentist sees only children and has the entire office set up for kids, from music, TV, giant kid-friendly murals, puppets and most importantly…sedation.

My general feeling about sedation is that if it is necessary to help your child have a great dental experience, then strongly consider it.  If you have to consider sedation as an option, please be sure to discuss with your dentist all of the risks involved with this type of chosen sedation.  While sedation is a great opportunity to complete your child’s dental care with ease, there are risks you should be aware of.  Though rare, there is the possibility of accidental death as a result of sedation and so the procedure should be considered only if truly necessary.  Due to the wide variety of sedation options and the fact that selection of the type of sedation varies by child,  I will not go into specific details.  Just inform yourself well and use that information to aid in making your decision.

By and large, the number one complaint I hear from my adult patients who are terrified to go to the dentist is that they had a traumatic childhood dental experience.  If we start out positively as a child, then we will have no reason to fear the dentist as an adult.  Going to the dentist regularly will become a desired, regular occurrence, like birthdays or  holidays.  Okay, okay, maybe I am exaggerating a little, but they still can be fun experiences for kids!

These bi-annual check-ups and cleanings allow us to catch problems while they are small, thereby keeping most dental procedures extremely conservative for both kids and adults.  I know it may seem hard to believe, but going to the dentist really can be an enjoyable (not just a tolerable) experience.

Much of what I will tell you in regards to nutrition will be similar to what you may have already heard from your obstetrician. Of course, nutrition is crucial to the overall health of both mother and child. A balanced and healthy diet can help mom feel well, avoid pregnancy complications such as gestational diabetes and aid in proper development of the baby.

But proper nutrition also plays a key role in the developing baby’s tooth enamel. Proper amounts of vitamins A, C and D, phosphorus, calcium and protein will help yield stronger, more decay resistant baby teeth in your child. Many of these vitamins and proteins are absorbed by consuming foods such as fruits, leafy vegetables, non-fish meats and low-fat dairy products. In addition, always add a prenatal vitamin to your diet unless your doctor says otherwise.

If you have never seen an x-ray of a newborns jawbone you may be surprised to see 20 developing teeth. So, even though you can’t see them, they are there. This is one reason that illness or injury as a toddler can have adverse effects on teeth later on. Your toddler’s first teeth are known as”primary” teeth and play an important roll in development. It is important for parents not to treat their child’s primary teeth as “temporary” or “replaceable” . Many preventable problems can be avoided by proper care of your toddler’s primary teeth.

At about six month of age, your toddlers teeth may be starting to erupt. The front four teeth are usually the first to arrive. Remember that ever baby develops at a different rate so if your toddler does not have his or her first tooth at 6 months+one day ,don’t sweat it! It is not uncommon for the first teeth to take 12 to 14 months to come in. Both of our boys seemed to take forever to get/lose teeth.

When your toddler’s teeth begin coming in(erupting), your child may experience sore or tender gums. This is normal. You can help soothe the discomfort by gently massaging the gums with a clean finger or moist gauze pad. Granted this will only provide temporary relief but sometimes that’s enough to help a fussy baby. If you prefer the “hands off” method, you can give your toddler a clean teething ring to chew on. Remember never to put any sugar or syrup on the teething ring. I know it seems obvious but as you may have guessed, there is a reason I mention it!

If your toddler is excessively uncomfortable and cranky, you can call your dentist or pediatrician to ask about over the counter pain remedies. Keep in mind also that contrary to popular belief, if your infant/toddler is running a fever while teething, this is not normal. Any unusually high or persistent fever is an indicator to contact your pediatrician.

Having a baby teeth chart is a great way to compare your child’s teeth with the average dental development of other children’s teeth. However, remember that this is just an “average” and many children will develop slower or faster than what is shown on this baby teeth chart.

The lower central incisors are usually the first to come in and may be followed quickly by the upper central incisors.

Next should be the lateral incisors followed closely be the first molars.

Canine teeth will be coming in somewhere in the 16 to 24 month range and lastly the second molars.

Remember that a baby teeth chart is simply a guide to assist you in det3ermining your childs dental development. There are also a lot more important things to learn about childrens teeth. Make sure that you are familiar with all of the issues affecting children’s teeth and dental development.

I would also like to mention that children’s teeth should by no means be considered “disposable” or unimportant. These little jewels will help pave the way for permanent teeth and may determine whether or not you as a parent will have to spend a great deal of money on orthodontic treatment later on.

So take good care of those baby teeth and use the baby teeth chart as a general and not a definite guide.

There have been many scientific developments in the field of oral health in the last decade. One of the most important studies has to do with the link between gum disease and several other health conditions. I won’t go into depth here about the other health conditions, as they don’t relate pregnancy but I will briefly mention them due to their extreme importance. There has been a proven relationship of gum disease to diabetic complications, stroke and heart disease. The oral bacteria which causes gum disease (which is different from those causing cavities) has been found in the heart and brain tissue of those who have had a fatal encounter with a stroke or heart attack. Diabetics with gum disease also experience more uncontrolled blood sugars. I would suggest a Google search the internet if you are interested in finding out more on the details of this relationship.

So, what does this have to do with pregnancy? Well, let me first give you a quick lesson on gum disease, since most of the population really doesn’t understand what it is. What it typically means to most people is the dreaded “you have to floss more” lecture from your dental hygienist. Basically, flossing your gums (notice I did not say teeth here) allows you to clean out the debris below the surface of your gums-in the area where popcorn kernels get caught. If that debris is not removed, it can turn into a concrete-like, bodily substance called “tartar” or “calculus” from the minerals in your saliva. This tartar can then become strongly adhered to the tooth root beneath the gums, causing inflammation which may be called gingivitis or gum disease.

Once tartar is present, it is not possible to be removed by flossing any longer. It will only come off with those dreaded scrapers we all hate at your dental cleaning appointment. Everyone gets tartar, but some people get it more abundantly than others either due to genetics, nutritional habits and/or mineral composition of saliva. This is why a dental cleaning or “prophylaxis” is needed every six months. It takes about six months for the body to develop enough tartar to elicit the start of the gum disease process.

If you don’t have your teeth cleaned, the tartar stays on the tooth root and allows more tartar to continue building on top of the existing tartar layer. This causes an even more inflammation of the gums. Eventually, the body “sees” this tartar layer as a “foreign object” and tries to get rid of through chemical and biologic means. So, this is good, right? Well, I have only told you part of the story. While the body is trying to help, it also releases special mediators that unfortunately destroy the bone around the teeth in an effort to get rid of the tartar.

If left untreated, the cycle of tartar deposited and more bone destroyed continues, causing the teeth to become loose. I always use the analogy of a “For Sale” sign in the yard-if you keep taking away the dirt around the big wooden post, eventually it becomes loose and falls out. Teeth are really as simple as that analogy. Eventually the teeth either fall out on their own, or have to be pulled because they cause a choking hazard.

In addition to this, pregnancy causes a huge hormonal shift which causes a lot more than tears, weight gain and cravings. An increase in the hormone progesterone during this time causes the gums to become more sensitive and prone to gum disease if plaque and tartar are not controlled. Signs of gum disease may be as follows: Sore, sensitive, swollen, red gums which may bleed spontaneously or especially while brushing or flossing. You may notice a black, yellow or brown, rough-appearing, grainy-looking substance along the gum-line of your teeth. You may also notice an increase in bad breath or a bad taste in your mouth.

You may hear your dentist call this process “gum disease” or “periodontal disease” (they mean the same thing) and they may tell you that you have “pockets” around your gums. These “pockets” are the popcorn-kernel-catching areas I was referring to earlier and get deeper with the deposition of more tartar over time. Certain ethnicities, such as African Americans and Hispanics are more genetically prone to getting gum disease. If you are of either of these descents, I strongly encourage you to see a dentist regularly and be sure that they are actually checking your gums every 6 months. Especially if your gums bleed when you floss or are highly sensitive.

So, of course we can see that one implication of gum disease as it relates to pregnancy would be the loss of teeth and therefore inadequate nutrition due to the inability to chew. While this is a huge concern, the primary concern is actually systemic in nature. Scientists have linked the presence of gum disease to increased incidence of pre-term delivery and low birth weight.

As mentioned earlier, the body’s attempts to resolve gum disease result in the release of bodily chemicals. These chemicals can cause the early onset of contractions, leading to pre-mature birth. Premature birth can cause a myriad of problems for the baby including, breathing difficulties (due to immature lung development), seizures and bleeding in the brain, difficulties in feeding and thus slow weight gain and poor nutrition. There are many other problems which can arise from pre-term labor and if you have concerns regarding this link with gum disease, talk to your physician and dentist. The best protection against this is to brush and floss regularly and to see your dentist regularly for a check-up and cleaning before, during and after pregnancy.

I know most people hate flossing (myself included) and despise going to the dentist. I know too that food is one of life’s greatest pleasures, especially during pregnancy. However, as parents, something in us changes and causes us to care for our children (event the unborn ones) and allows us to do the best for our children. Modification of routines and following a few simple guidelines will only eliminate one more thing to have to worry about during pregnancy. They are factors which we can control when so many other things during this amazing time are out of our control.

There is, what I call a dental “urban legend” which I hear from 90% of my patients who are also mothers: “I never had cavities until I had my first child-now I have a cavity for each child born! ” I know from personal experience that pregnancy can bring about many new symptoms, most not enjoyable, few which are. Some symptoms I had, were an insatiable appetite, strange cravings and peculiar repulsion of things I normally enjoyed. Unfortunately, I did not get repulsed by chocolate, desserts or picnic foods like some lucky mothers do. I have found through my experience of two pregnancies, that most other moms experience the same. And so, the junk-food and snacking festivities often begin with the onset of pregnancy.

While typically, as a woman, we may also be concerned with excess weight gain during pregnancy, there is yet a bigger danger lurking beneath the moon-pies and chocolate chip ice cream. It is called CAVITIES! An increase in frequency of snacking, even with healthy items such as fruits and whole grain breads can cause cavities to crop up without any warning. Let’s face it, the last thing on our minds as a pregnant woman is our teeth. We are typically overwhelmed with other essentials such as, what color stroller and car-seat we want or how to use the crazy looking apparatus called a breast pump.

So, how do we combat these cavity-causing snacking frenzies? Well, as a mother, I am not about to tell you to stop snacking, as that would likely induce some tears followed by more snacking. What I will tell you is that if you increase your snacking, be sure to increase your tooth-brushing. Cavities are formed by bacteria in your mouth and on your teeth which feed on the snacks you provide for them. A bacterial layer is created on the surface of your teeth and can easily be removed with your tooth brush. No need to brush hard, as this can cause damage to your teeth. The best type of toothbrush to use is a “sonicare” or “Oral-B” electric toothbrush. They do a remarkable job. However, a soft nylon bristled tooth brush is fine as well. Make sure you use a fluoride containing toothpaste and brush at least three times a day. You can use over-the-counter mouthwashes if you like, just be careful not to ingest them.

Snacking is not the only worry when it comes to cavities. Many moms experience gastro-esophageal reflux during pregnancy, and it can often be severe. This constant exposure of stomach acids to the mouth causes the teeth to be more prone to cavities for many reasons. If you are suffering from heart burn, or gastro-esophageal reflux, then be sure you are rinsing your mouth or drinking plenty of water and limiting the amount of sugary snacking you do. You may want to talk to your obstetrician about medication and diet options if you feel it is severe.

The other reason keeping cavities away in mom is important, is that the bacteria that cause cavities can be passed along to your newborn. Yikes!

With this in mind, I strongly suggest that you see your dentist prior to attempting to conceive. If you are a planner of course! The best scenario is to have a check up and complete any necessary work before getting pregnant. In general, once you become pregnant, no dental treatment is done unless it is a true emergency. This is because we use certain medications and x-rays which can be harmful to the baby, especially during the first trimester. It is not to say that if we have to use them in an emergency that they will definitely cause damage to the developing baby, however, we would rather not take any chances. So, x-rays and routine dental work are often postponed until after delivery. If you see your dentist before conception, you may abate any emergencies by performing the needed care before it actually becomes an emergency.

Also, any dentist worth a pinch of puppy poo should ask if you may be pregnant. If they don’t, make sure to tell them. Or go find a more conscientious dentist!